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Using Virtual Simulation to Teach Inclusivity: A Case Study
Abstract
Background: The topics of inclusivity, diversity, and cultural awareness are difficult to adequately explore in a traditional classroom setting. The use of the virtual platform of Second Life® afforded a unique opportunity to use virtual role-play simulation to experience what it is like to walk in another's shoes. Method: Fifteen graduate nurse educator students enrolled in a course titled "Inclusivity in Nursing Education" were randomly assigned a customized avatar, representing a marginalized person for use in a role-play simulation in the virtual world of Second Life®. Two written assignments regarding the learning experience were evaluated using a simple qualitative analysis. Results: Students indicated that they increased their own capacity to understand, appreciate, and relate to people different from themselves. Conclusion: Although future research is needed to determine the full extent to which virtual platforms can be used effectively in nursing education, this case study demonstrated that valuable learning regarding complex topics can take place in the virtual world. © 2016 International Nursing Association for Clinical Simulation and Learning.
... Statistically significant gains were demonstrated in cultural knowledge and intentions of students to prolong civic engagement or pursue work in underserved communities (DeBonis, 2016). Three studies investigated cultural competencies of graduate nursing students through simulation, either with virtual experiences (Tiffany & Hoglund, 2016) or with racialized standardized patients during objective structured clinical examinations (Ndiwane et al., 2014(Ndiwane et al., , 2017. The latter two studies reported statistically significant gains in students' cultural knowledge. ...
... Four studies centered on themes of implicit or unconscious bias. Three of these studies focused on engaging students to More than 80% of respondents agreed too little time was spent on disabilityrelated content in their respective programs, most often attributed to lack of space and time for additional content; 85% reported their programs used the medical model of disability, which views the disability as the problem recognize implicit bias (Schultz & Baker, 2017;Tiffany & Hoglund, 2016;Vandermause et al., 2021). The fourth study aimed to expand students' phronesis, or practical wisdom, to apply toward broader nursing ethical frameworks (Marlow et al., 2015). ...
Background:
Advancing inclusivity in graduate nursing education is paramount for preparing diverse nursing leaders to mobilize change within health care and educational systems. This scoping review examined inclusivity in graduate nursing education.
Method:
CINAHL, Medline, and ERIC databases were searched for studies published in English since 2011. Key journals and reference lists of included studies were hand searched. Included studies focused on inclusivity in the context of graduate nursing education.
Results:
Data from 31 included studies are presented. Most of the studies (n = 22) aimed to cultivate inclusivity among students, primarily through cultural competence training. A few studies enacted inclusivity through program-level strategies (n = 4) or explored the lived experiences of diverse students (n = 5).
Conclusion:
Future research and education initiatives should advance a more holistic, intersectional approach to cultivating inclusivity, as well as emphasize enacting inclusivity through strategies to transform the learning environment. [J Nurs Educ. 2022;61(12):679-692.].
... However, there are few studies on nurse educators' perspectives of virtual simulation effectiveness. Early studies evaluating faculty perceptions of virtual simulation have suggested its' capacity to improve learning outcomes ( Jenson & Forsyth, 2012 ;Tiffany & Hoglund, 2016 ). One study explored faculty's readiness to integrate virtual simulation in teaching intravenous catheter insertion skills resulting in positive evaluation of its' benefits and value ( Jenson & Forsyth, 2012 ). ...
... One study explored faculty's readiness to integrate virtual simulation in teaching intravenous catheter insertion skills resulting in positive evaluation of its' benefits and value ( Jenson & Forsyth, 2012 ). In a course using Second Live for graduate nurse educator students, findings revealed increased personal awareness of attitudes, biases and judgements with related appreciation and understanding of persons different from oneself ( Tiffany & Hoglund, 2016 ). Virtual simulation can be perceived as a practical teaching pedagogy, especially when faculty are equipped to fully participate in the process. ...
During the COVID-19 pandemic, clinical nurse educators within pre-licensure baccalaureate educational programs had to quickly adapt to new ways of teaching. Hospital-based clinicals no longer permitted students to attend and some schools of nursing (SON) transitioned to virtual simulation learning environments. These alternative learning strategies were imperative for students continued progression. The first purpose of this pilot study explored nursing faculty's perceived effectiveness of using vSim for Nursing® to replace clinical practice. A second purpose examined the effectiveness of faculty preparation.
Effectiveness was evaluated using an adapted version of the Simulation Effectiveness Tool – Modified (SET-M). Mean scores indicated that faculty strongly agreed on its effectiveness for students’ learning, with all items ranging 57.9%-97.4%. Majority of faculty strongly agreed that their preparation was highly effective, ranging 86.8%-97.4%. Faculty perceived vSim for Nursing® to be an effective tool for replacement of clinical practice and felt prepared to meet the students’ learning outcomes. Evidence to support the effectiveness of vSim is needed so faculty can make data driven decisions to support student success in clinical practice. Debriefing continues to be a prominent component to any form of simulation. Supporting and preparing faculty to meet students’ competencies further ensures successful transition as a professional.
... P<.001; d=1. 33). The students in the experimental group presented better outcomes in knowledge retention and learning satisfaction than students in the control group. ...
... These results are in line with the results of other studies, where the authors found that levels of knowledge [31][32][33] and satisfaction [14] with the learning process improve with the use of virtual simulation. ...
[This corrects the article DOI: 10.2196/11529.].
... Chen et al. established a psychological virtual simulation experiment teaching system according to the user needs of different personnel and found that the system has strong practicability 20 . Tiffany et al. studied virtual simulation cases, and the results showed that students improved their understanding ability and interaction ability 21 . He et al. analyzed the development of the virtual simulation experiment teaching platform, and expanded the practical content and training methods of the Unmanned Aerial Vehicle experiment 22 . ...
For safety engineering majors, it is very important to cultivate the practical ability of professional talents. Due to the difficulty of conducting experiments in dangerous environments, a virtual simulation experiment teaching platform was established. The platform allowed students to understand the structure of the subway ventilation room, and master the control requirements of the ventilation system in the event of sudden fire, blockage, and failure in the subway. Its construction used technologies such as 3D modeling, human–computer interaction, and VR. To test the teaching effect of the simulation experiment platform, two indexes of operating skills and cognitive load were selected to study and analyze the experimental results of students. The research adopts the method of stratified sampling, 46 boys and 10 girls were selected from the first-year students majoring in safety engineering, and they were randomly divided into experimental group and control group, with 23 boys and 5 girls in each group. The experimental group used the simulation platform for teaching, while the control group used the traditional teaching method. The score of the assessment module in the platform was taken as the index of students’ operating skills, and the cognitive load test was carried out by questionnaire to test the teaching effect. The test module scores showed that the average score of the experimental group was 32.79 points higher than that of the control group, and the results of the cognitive load test questionnaire showed that the experimental group scored 35.14% lower than the control group. The research shows that the virtual simulation experiment has a stronger teaching effect than the field experiment.
... In VR environments, educators and trainers can design gamified scenarios for their teaching and training purposes in settings that are either impossible to replicate or too costly in the natural world. With the fast advancement of VR technologies in recent decades, researchers and practitioners have been applying VR in various instructional and training settings, such as medical training, professional simulations, and school education (e.g., Andersen, Konge, & Sørensen, 2018;Chang & Weiner, 2016;Cho et al., 2013;Ke, Lee, & Xu, 2016;Leder, Horlitz, Puschmann, Wittstock, & Schütz, 2019;Nagendran, Gurusamy, Aggarwal, Loizidou, & Davidson, 2013;Smith & Hamilton, 2015;Sugden et al., 2012;Tiffany & Hoglund, 2016). The infinite research possibilities that serious games in VR can provide also invite challenges in the areas of assessment and evaluation being studied. ...
Well-designed video games provide exciting prospects for teaching, training, learning, and research. Moreover, immersive virtual reality (VR) environments offer flexibility to design learning and training scenarios that are authentic. Gameplay in immersive environments often requires players to test and refine new strategies when confronted with progressively more challenging scenarios where learning from failure is a function of game design. Over time, players hone their skills through internal game mechanics and interactions with the environment, such as feedback and pedagogical agents to support long-term learning. This is known as productive failure. However, there are still challenges in assessing learners’ targeted competencies, for example, problem-solving skills, during video gameplay. In this chapter, we examine how student interactions during gameplay can be assessed in immersive environments without disrupting the flow of gameplay. This type of assessment is known as stealth assessment. We also describe the challenges with assessing productive failure in game-based learning and implications for future research on assessment of learning in immersive environments.
... This is in line with previous research showing an improved learning process when using VP cases. The use of VP cases as a pedagogical strategy has shown improved knowledge retention and clinical reasoning in addition to increased student satisfaction (Padilha et al., 2018;Tschannen et al., 2012;Sperl-Hillen et al., 2014;Tiffany & Hoglund, 2016). This study showed that students experienced the VP cases to be realistic and similar to clinical practice, and they described VP cases as an important opportunity to train abilities such as pattern recognition, clinical reasoning, and clinical decision-making. ...
... These results are in line with the results of other studies, where the authors found that levels of knowledge [31][32][33] and satisfaction [14] with the learning process improve with the use of virtual simulation. ...
... Many types of simulation exist, including high fidelity, often set in a laboratory (Cant & Cooper, 2009;McGovern, Lapum, Clune, & Schindel-Martin, 2013); however, challenges are involved, such as costs related to creating, operating, and maintaining simulation laboratories (Gates, Parr, & Hughen, 2012). Other nontraditional simulation approaches in nursing education include computerized virtual learning using Second Life ® and avatar-based programs, as well as serious gaming modalities (De Gagne, Oh, Kang, Vorderstrasse, & Johnson, 2013;Nelson, 2016;Tiffany & Hoglund, 2016). Although these tools offer novelty and are adaptive to student learning, a paucity of research that examines students' experiences of virtual gaming simulation exists. ...
Background:
The use of serious gaming in a virtual world is a novel pedagogical approach in nursing education. A virtual gaming simulation was implemented in a health assessment class that focused on mental health and interpersonal violence. The study's purpose was to explore students' experiences of the virtual gaming simulation.
Method:
Three focus groups were conducted with a convenience sample of 20 first-year nursing students after they completed the virtual gaming simulation.
Results:
Analysis yielded five themes: (a) Experiential Learning, (b) The Learning Process, (c) Personal Versus Professional, (d) Self-Efficacy, and (e) Knowledge.
Conclusion:
Virtual gaming simulation can provide experiential learning opportunities that promote engagement and allow learners to acquire and apply new knowledge while practicing skills in a safe and realistic environment. [J Nurs Educ. 2017;56(5):274-280.].
Background:
Despite recommendations to include disability content in nursing education, nursing students have little exposure to disability education, which would help to develop necessary knowledge, skills, and attitudes in learning to care for patients with disabilities.
Purpose:
This study evaluated learners' perceptions of the effectiveness of a tabletop simulation in meeting their learning needs related to nursing care for children with disabilities and their families.
Methods:
The research design was a descriptive educational intervention study. Nursing students (n = 234) enrolled in the pediatric nursing course attended the simulation as a required part of their coursework.
Results:
The majority of the students found the tabletop simulation with disability content to be an effective educational intervention.
Conclusions:
The results obtained from this study indicated that the tabletop simulation was an effective educational strategy for nursing students' learning to provide care for children with disabilities and their families.
Nursing students receive limited education to prepare them for providing quality nursing care to people with disabilities. The aim of this article is to provide the state of the science, or what is known, about nursing simulation with disability content to provide direction for nursing education and research in the future. Thirteen studies were reviewed and appraised in this integrative review. This review revealed three major student-related study outcomes for simulation activities: (a) empathy, (b) understanding and awareness, and (c) communication and disability. Only a few studies integrated a definition of a disability and specified the disability model to guide the development of the simulation activity. This review revealed limited research on the use of simulation with disability content in nursing education. The findings indicate there is a need for nurse educators and researchers to use best practices, such as a competency-based approach, when integrating simulation activities with disability content into the nursing curriculum.
Increased training is necessary to ensure that the next generation of health care professionals are prepared to effectively and compassionately serve patients with Alzheimer’s Disease. Second Life® is a virtual world shown to provide a safe, convenient, and effective environment for teaching health-related content. To date, there has been no comprehensive review of studies using Second Life in education about Alzheimer’s Disease. The authors conducted a scoping review of the literature on the use of Second Life in the education of medical, nursing, and health professions students about Alzheimer’s Disease. Searches were conducted in PubMed, SCOPUS, and CINAHL. Thirty-two studies containing outcomes of the application of virtual reality and the virtual world Second Life were identified. Studies were classified using the Kirkpatrick Four-Level Training Evaluation Model. Changes in knowledge, attitudes, and confidence (Level 2), were most commonly reported, followed by positive reactions (Level 1). No studies identified system-level results and few examined changes in behavior. While results indicate positive student reactions and enhanced learning from Second Life interventions related to Alzheimer’s Disease, they also highlight a need for future research examining outcomes at the higher Kirkpatrick levels.
Background
Virtual simulation research focusing on comparison of perceptions between students from different types of graduate nursing programs is limited. The purpose of this study was to explore the use of virtual simulation to experience difficult conversations and to evaluate differences in perceptions between nurse educator (NE), family nurse practitioner (FNP), and nurse anesthesia (NA) students.
Method
Virtual simulations focusing on suicide awareness, opioid misuse, and conflict resolution were implemented.
Results
A total of 105 students participated. The majority perceived virtual simulation as realistic and applicable to practice. FNP students were more likely to have experienced a similar situation in practice prior to simulation than NA and NE students. Overall rating of the simulation was significantly higher among FNP and NE students compared to NA students.
Conclusions
Virtual simulation is useful for experiencing challenging interactions that might not be encountered in practicum. Further research is needed to evaluate long-term application into practice.
The pandemic, produced by covid-19, gave rise to a new normal, in which education is part of that change. In certain cases, the quality of education was affected, either by factors such as deficient online teaching material, teaching issues, attention, and adaptation problems on the part of students in their online courses. To help improve performance in online education, some educational institutions have chosen to use the virtual world of Second Life to implement it in their classes, offering features that benefit learning from home, making it more didactic and enjoyable for students. The objective of this article is to find and analyze the critical success factors for the implementation of Second Life in virtual classrooms, through the construction of fuzzy cognitive maps. The use of forms aimed at students is proposed, from which the results will be evaluated and the factors that influence a quality education will be determined, building a fuzzy cognitive map for their understanding.
Statement:
As virtual simulation is burgeoning, faculty and administrators are asking for evidence of its effectiveness. The objective of this systematic review was to identify how virtual simulation impacts nursing student learning outcomes. Applying the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, 80 studies were reviewed. Results indicate that most research (n = 69, 86%) supported virtual simulation as an effective pedagogy to support learning outcomes while highlighting gaps and areas of bias. Adding search terms could have expanded the findings. The body of evidence supports virtual simulation as an effective pedagogy. Future studies should use more robust research designs, prioritize curricular integration of virtual simulation, and determine best practices in virtual simulation methodology.
Background
In the field of health care, knowledge and clinical reasoning are key with regard to quality and confidence in decision making. The development of knowledge and clinical reasoning is influenced not only by students’ intrinsic factors but also by extrinsic factors such as satisfaction with taught content, pedagogic resources and pedagogic methods, and the nature of the objectives and challenges proposed.
Nowadays, professors play the role of learning facilitators rather than simple “lecturers” and face students as active learners who are capable of attributing individual meanings to their personal goals, challenges, and experiences to build their own knowledge over time.
Innovations in health simulation technologies have led to clinical virtual simulation. Clinical virtual simulation is the recreation of reality depicted on a computer screen and involves real people operating simulated systems. It is a type of simulation that places people in a central role through their exercising of motor control skills, decision skills, and communication skills using virtual patients in a variety of clinical settings.
Clinical virtual simulation can provide a pedagogical strategy and can act as a facilitator of knowledge retention, clinical reasoning, improved satisfaction with learning, and finally, improved self-efficacy.
However, little is known about its effectiveness with regard to satisfaction, self-efficacy, knowledge retention, and clinical reasoning.
Objective
This study aimed to evaluate the effect of clinical virtual simulation with regard to knowledge retention, clinical reasoning, self-efficacy, and satisfaction with the learning experience among nursing students.
Methods
A randomized controlled trial with a pretest and 2 posttests was carried out with Portuguese nursing students (N=42). The participants, split into 2 groups, had a lesson with the same objectives and timing. The experimental group (n=21) used a case-based learning approach, with clinical virtual simulator as a resource, whereas the control group (n=21) used the same case-based learning approach, with recourse to a low-fidelity simulator and a realistic environment. The classes were conducted by the usual course lecturers.
We assessed knowledge and clinical reasoning before the intervention, after the intervention, and 2 months later, with a true or false and multiple-choice knowledge test. The students’ levels of learning satisfaction and self-efficacy were assessed with a Likert scale after the intervention.
Results
The experimental group made more significant improvements in knowledge after the intervention (P=.001; d=1.13) and 2 months later (P=.02; d=0.75), and it also showed higher levels of learning satisfaction (P<.001; d=1.33). We did not find statistical differences in self-efficacy perceptions (P=.9; d=0.054).
Conclusions
The introduction of clinical virtual simulation in nursing education has the potential to improve knowledge retention and clinical reasoning in an initial stage and over time, and it increases the satisfaction with the learning experience among nursing students.
Three Dimensional Multi-User Virtual Environments (MUVEs) are promising tools in education because of the unique affordances they offer. These learning affordances imply certain actions that in turn can lead to corresponding learning activities. There seems to be a lack of reports on which of the affordances of MUVEs for learning and teaching are used and how they are enacted by relevantly designed learning activities. This study investigates the learning activities conducted in Second Life, the most popular and widely used among the "sandbox" type MUVE platforms, as reported in 205 empirical studies, by associating them with the learning affordances they enact. As necessary step towards this goal, the study proposes a new classification of learning affordances of MUVEs and a new concrete set of learning activities based on the literature review. Learning affordances include free navigation, creation, modeling and simulation, multichannel communication, collaboration and cooperation and content presentation and/or delivery. By using the open, axial and selective coding offered by the grounded method, the learning activities that emerged from the exhaustive empirical review, are well associated with the proposed six learning affordances, validating in return the functionality of the proposed set of learning affordances. The five more general learning activities, resulting from the selective coding, are content creation, content exploration and interaction with content, social interaction, gaming, participation in representations of real life events and situations. Further research on other MUVEs is needed to establish this framework.
Background
Use of theory is essential for advancing the science of knowledge translation (KT) and for increasing the likelihood that KT interventions will be successful in reducing existing research-practice gaps in health care. As a sociological theory of knowledge, social constructivist theory may be useful for informing the design and evaluation of KT interventions. As such, this scoping review explored the extent to which social constructivist theory has been applied in the KT literature for healthcare professionals.
Methods
Searches were conducted in six databases: Ovid MEDLINE (1948 – May 16, 2011), Ovid EMBASE, CINAHL, ERIC, PsycInfo, and AMED. Inclusion criteria were: publications from all health professions, research methodologies, as well as conceptual and theoretical papers related to KT. To be included in the review, key words such as constructivism, social constructivism, or social constructivist theories had to be included within the title or abstract. Papers that discussed the use of social constructivist theories in the context of undergraduate learning in academic settings were excluded from the review. An analytical framework of quantitative (numerical) and thematic analysis was used to examine and combine study findings.
Results
Of the 514 articles screened, 35 papers published between 1992 and 2011 were deemed eligible and included in the review. This review indicated that use of social constructivist theory in the KT literature was limited and haphazard. The lack of justification for the use of theory continues to represent a shortcoming of the papers reviewed. Potential applications and relevance of social constructivist theory in KT in general and in the specific studies were not made explicit in most papers. For the acquisition, expression and application of knowledge in practice, there was emphasis on how the social constructivist theory supports clinicians in expressing this knowledge in their professional interactions.
Conclusions
This scoping review was the first to examine use of social constructivism in KT studies. While the links between social constructivism and KT have not been fully explored, the Knowledge to Action framework has strong constructivist underpinnings that can be used in moving forward within the broader KT enterprise.
In this paper, we discuss an approach to providing students with first-hand learning experiences that help them understand cultural differences and aspects of diversity. As part of a five-week course, fourteen high school students participated in activities within massively multiplayer online games (MMOGs) as learning environments to explore issues of identity construction, discrimination, and cultural sensitivity. Student attitudes towards diversity and towards the technology used in the course are discussed. The students reported using the tool to explore and to equalize cultural and demographic differences. They showed significant improvement on a measure of sensitivity towards an understanding of diversity, and evidence suggests they were able to develop a more sophisticated, less essentialist model of diversity.
Racial microaggressions are brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color. Perpetrators of microaggressions are often unaware that they engage in such communications when they interact with racial/ethnic minorities. A taxonomy of racial microaggressions in everyday life was created through a review of the social psychological literature on aversive racism, from formulations regarding the manifestation and impact of everyday racism, and from reading numerous personal narratives of counselors (both White and those of color) on their racial/cultural awakening. Microaggressions seem to appear in three forms: microassault, microinsult, and microinvalidation. Almost all interracial encounters are prone to microaggressions; this article uses the White counselor--client of color counseling dyad to illustrate how they impair the development of a therapeutic alliance. Suggestions regarding education and training and research in the helping professions are discussed.
The Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health provides direction for educators to use simulation and Web-based learning. Virtual clinical simulation (VCS) is an innovative approach offering Web-based simulations. The aim of this article is to provide an integrative review of the literature and explore the state of the science of VCS in nursing.Method
The Cumulative Index to Nursing and Allied Health Literature database and Medline were explored, and 86 articles were selected as relevant and reviewed.ResultsOnly 3 studies were located that formally examined the use of VCS in nursing.ConclusionVCS is an emerging educational venue that warrants further investigation.
Virtual simulation, using avatars through synchronous, multiplayer virtual worlds, is an engaging and meaningful way to teach high-level skills online in nurse education. The aim of this article was to present strategies for incorporation of virtual simulation in nurse to education and to provide an approach to get started. Virtual simulation may be used by educators to enhance lecture or web-based courses, replicate high-risk clinical experiences, act as clinical makeup, foster intradisciplinary and interdisciplinary education, and address practical challenges and barriers to contemporary nursing education.
The purpose of this study was to test the use of virtual simulation to improve teamwork among nursing staff. Using a quasi-experimental design, nursing staff (n = 43) from one patient care unit participated in a 1-hr session, which focused on common nursing teamwork problems. The overall mean teamwork scores improved from pre- (M = 3.25, SD = 0.58) to post-intervention (M = 3.49, SD = 0.67, p < .012). The intervention also had large (0.60 ≤ d ≤ 0.97) and significant effects on the measures of three teamwork subscales (i.e., trust, team orientation, and backup).
Background
Innovative teaching/learning strategies that simulate real world situations are needed. The virtual world of Second Life (SL) provides an opportunity for nurse-educators to develop meaningful, simulated learning experiences that are transferrable to the real world of nursing practice.
Methods
Students enrolled in a graduate nursing education course were invited to complete pre- and post-activity surveys regarding perceptions and experiences related to using SL as a teaching/learning strategy.
Results
The simulated role play experience in SL helped 10 of 11 students to apply concepts regarding the lived experience of marginalized persons. Seven described a meaningful learning experience; 11 reported a sense of presence and connectedness. Barriers and challenges related to technology, self-efficacy, and communication within the virtual world were identified.
Conclusion
With careful planning, the use of SL as an innovative teaching/learning strategy for nursing education was validated.
Clinical experience remains the foundation of practice disciplines such as nursing. Multiple factors such as shortage of nursing faculty and increasingly competitive clinical sites have encouraged nurse educators to seek alternative pedagogies to supplement traditional hands on clinical practice. Standardize patients and clinical simulation scenarios have evolved as reliable tools to enhance clinical education. However, their high costs and resource intense nature often limit their use. Distance education is an effective and accepted educational modality in our ever-changing, highly technical world. However, many distance education courses are limited to presenting didactic content and lack the capability to offer skills-based clinical education. Virtual reality experience is an interactive Internet-based approach to providing clinical education in a safe, nonthreatening environment that offers increased access and flexibility to the learner. This article explores the benefits and challenges of the virtual reality experience approach to supplement clinical practice and nursing.
As increasing numbers of educators explore the use of virtual worlds for education, there is a need to consider which pedagogical approaches can provide an opportunity to do more than recreate the traditional classroom by leveraging the unique characteristics and potential that the technology can offer. This study identifies Communal Constructivism as a potentially appropriate pedagogy for use in the virtual world Second Life. Five groups of learners took part in a learning experience specifically designed to provide opportunity for the features of Communal Constructivism to emerge through the affordances of the technology. The chat logs, learning artefacts, post-activity semi-structured interviews and researcher’s observations from each of the five groups were analysed to explore participants’ experiences and both the operation and outcome of the pedagogy in action. Findings from the qualitative analysis of the data sets indicate that learners collaboratively constructed knowledge for themselves as a group and for others, as the features of the pedagogy emerged.
Introduction: health professionals must address culture and diversity in practice. Clinical assessment and treatment have been linked to race and ethnicity (Schitai, 2004, Smedley et al., 2003). Research has addressed culture and diversity in traditional learning environments (Ladson-Billings, 1995; Grant and Sleeter, 2006), yet, little exists related to virtual communities. This is troubling because virtual environments are increasingly being used as platforms for indoctrination, communication, and assessment for clinical education. Theoretical framework: virtual communities encourage participants to 'try on' different identities (Gee, 2003), and reflect on the consequences of their decisions while 'wearing' them. This paper introduces a new framework: the ecology of culturally competent educational design, providing a launching point for development and evaluation of cultural competence in virtual worlds. Conclusion: virtual worlds provide a useful and safe medium for integration of cultural competence training in clinical education, which is paramount because it influences patient diagnosis and outcome.
This paper is a report of a study to determine the impact of the preceptor coaching component of a reflective contextual learning intervention on novice nurses' critical thinking skills during the first 6 months of their practice.
The use of preceptors to develop novice nurses' clinical skills has been well documented in the literature. However, there is little literature focused on preceptor involvement to develop novice nurses' critical thinking.
This small case study was conducted in the United States of America in 2004 with six nurse/preceptor dyads. Stake's qualitative instrumental case study design was used to evaluate the preceptor component of the contextual learning intervention. Stories of preceptor experiences were analyzed using Stake's phases of data analysis (i.e. description, categorical aggregation, establishing patterns, naturalistic generalizations). Specific questions (e.g. nature of coaching used by the preceptor) guided the analysis. Repeating patterns were coded and isolated and later collapsed as the analysis moved forward.
Preceptors use of the contextual learning intervention created a context that stimulated novice nurses' critical thinking. Two main themes describe the novice nurses' critical thinking skills relative to the preceptor coaching: 1) critical thinking as organizing and carrying out tasks; and 2) critical thinking as intentional, reflective thinking.
Preceptor education should incorporate the following components: understanding the impact of power and anxiety on critical thinking of novice nurses transitioning into practice; creating dialogue that invites questions in a reflective and critical manner; and challenging thinking through sharing of perspectives.
Nursing presence in clinical practice.
To explore the concept of presence within the nursing literature.
Published literature.
True presence creates the opportunity for nurses to go where the patient is in life, to learn about the experience of health as it is defined and lived, and to work with patients as they choose the meaning of the situation.
Virtual learning spaces: Using new and emerging game-based learning theories for nursing clinical skills development
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Striving for cultural competency by leveraging virtual reality and game-based learning
- R Pyburn
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